Diaphragm



Jan. 16, 1951 w, SNELL 2,538,478

DIAPHRAGM Filed June 16, 1947 INVENTOR WALTER A. SNLL ATTORNEY Patented Jan. 16, 1951 umo STATES gram" orsic 6 Claims- 1 The present invention relates to vaginal diaphragms in general and particularly to a vaginal pessary suitable for the treatment of uncomplicated displacements of the uterus, and particularly characterized by the ease with which it may be inserted and by the certainty with which it maintains its position after being properly located.

Basically, there are three types of diaphragms prescribed and fitted by physicians ranging roughly from 50 to 95 millimeters in diameter. All have in common a resilient peripheral rim or ring closed upon one side by a thin flexible sheet of flexible material. Also in common is the purpose of supporting and covering certain parts of the vaginal vault. The priorart devices may be classified broadly according to the characteristic of the peripheral rim, as the coil spring diaphragm type, thefiat spring diaphragm type, and the arc diaphragm type.

The well known coil spring diaphragm type is provided in its peripheral ring with a circular coil spring, the coil diameter of which varies with different manufacturers. This type of diaphragm is flexible in three planes and has the advantage of. being relatively comfortable and flexible in any direction after being positioned. Additionally it is advantageous in that it may be positioned without mechanical aids. I ha the disadvantage, however, of being difiicult to position in case of abnormalities, such as cystocele, rectocele, retroversion, antroversion and prol'apsus. Also it is displaced accidently with comparative ease.

The flat spring type diaphragm is characterized by the provision within its peripheral rim of a flat steel spring comprising a.seotion from a cylinder which is accordingly relatively inflexible in one plane. This type has the advanta e of being easily inserted manually. Additionally it is quite satisfactory in the case of abnormalities, being characterized by its relatively great rigidity as a sup ort in a vertical plane. It has the distinct disadvantage, however, in that it has the tendency to slip from its position accidentally and to be distorted with repeated use. Some women find it to be uncomfortable because of its rigidity.

The are diaphra m type is provided in its rim with two coil springs, one of which is positioned against the outer circumference of the other in an off-set manner so that when a compressive force is exerted at two diametrically opposite points the curved sections. formed between the two points will. arc. upwardly. This 2 has the advantage that it fits well within the normal vaginal vault and is not easily displaced. Additionally it is relatively comfortable and satisfactory in the case of abnormalities. It has a disadvantage, however, in that it is almost irrpossible to insert by hand because of its flexibility and require the use of a mechanical inserter. Its relatively wide rim is found by many to be uncomfortable, and because of its extreme flexibility or softness does not give as much support as is frequently required. Additionally its flexibility sometimes results in flexing or arcing in the opposite direction from that intended and desired.

With an understanding of the problems and defects of the constructions of the prior art it is an object of the present invention to provide an improved easily insertable pessary or diaphragm'which is simple inits construction, cornfortable when in position, and positive in its tendency to retain its place after once being properly positioned.

It is another object of the invention to provide a removable diaphragm which arcs upwardly at its ends when pressed together at its sides and which has sufiicient strength as to enable it to be inserted manually without the assistance of mechanical devices.

A still further object of the invention is to provide a vaginal diaphragm so constructed as to form an arcuate curve upon the rec ption of side vention;

Figure 2. is a view, partly in section, showing the contours assumed by the unit. upon the exertion of compressive forces at diametrically opposed points on. the rim;

Figure 3 is a view looking in the direction of the arrows on the line 3-3 of Figure 2 and shows the curved contours assumed by the diaphragm proper upon the compression of rim;

Figure 4 is a top view looking downwardly upon a rriizetallic spring adapted to be embodied in the uni Figure 5 illustrates the spring conditioned for positioning in the unit;

Figure 6 is a section upon the line G6 of Figure 3;

Figure 7 is a section similar to Figure 6 through a second preferred embodiment in which a coil spring encircles the frusto-conical spring;

Figure 8 is a section similar to Figure 6 through a third preferred embodiment in which a coil spring is positioned interiorly of the frusto-conical leaf spring; and

Figure 9 is a a similar section through a fourth preferred embodiment of the invention in which the coil spring is positioned exteriorly of the frusto-conical leaf spring.

Figure 16 shows the device as used in a patient.

The improved diaphragm constructed in accordance with the first preferred embodiment of the present invention is illustrated in Figures 1 to 3, inclusive, the spring element forming an integral part thereof being illustrated in Figure 4, and in its condition as prepared-for positioning in the mold, in Figure 5. The diaphragm, which term may be used to indicate the entire construction which includes the diaphragm proper, comprises a relatively thick circular sectioned peripheral ring or rim H from one side of which extends a very thin flexible wall or diaphragm proper l2, preferably formed integrally therewith, as in molding. The material is prei erably extremely flexible, resilient, water-proof and impervious to air and water. Rubber, both synthetic and natural, is suitable. Embedded within the rim l is a coiled flat spring l3, illustrated by itself in Figures 4 and 5. While spring i3 is described as a flat spring because it is flat in any transverse section, actually it conforms to the surface of a cone so that when assembled in the relationship illustrated in Figure 5, in which it is secured by means of a sleeve I4, it in fact forms a very small height frusto cone. In the molding of the unit the spring I3 is first positioned in the die and the flexible material of the rim ll formed therearound so that it is completely embedded and protected on all sides.

By virtue of the presence of spring It, the lower circumference of which is longer than the upper circumference, as illustrated in Figures 1 and 2, a side pressure exerted upon diametrically opposite sides of the rim alters the diaphragm from its normally circular shape, illustrated in dotted lines in Figure 3, to an ellipse having an arcuate contour, as is illustrated most clearly in Figure 2. The new contour necessarily results from the fact that as the opposed points of the rim are forced together the lower circumference of the spring, being longer than the upper, must assume a position which will accommodate its longer length. Accordingly, the rim changes from the flat substantially single plane form of Figure l to the arcuate shape of Figure 2. The central flexible wall 52 is drawn, as aresult of the shape assumed by the rim, into the contours illustrated in Figures 2 and 3, in which a central channel It is defined by parallel oppositely curved channels ll.

Referring now to Figure in particular, the operative position of the diaphragm constructed in accordance with the present invention is illustrated diagrammatically within the female vaginal vault. The vault proper is indicated by the reference character 21 and is seen to be positioned below the pubic bone 22. A notch or recess 23 in the upper surface of the vault, designated as the symphysis pubis or notch of the pubic arch, is particularly important in connection with the retention of the diaphragm within the vault. The uterus, indicated at 2%, opens into the vault at the cervix, indicated at The detailed mention of the surrounding parts, which are illustrated in their general relationship, is not necessary to an understanding of the application and usefulness of the diaphragm comprising the present invention.

Before insertion of the diaphragm into the vaginal vault a lateral force is exerted upon the opposed sides of the rim ii to force the unit into the arcuate elliptical conformation illustrated in Figures 2 and 3. Actually at the time of insertion the deformation could be still greater than that illustrated. The unit may then be shoved manually by the fingers rearwardly into the vault and, if properly selected, is of such size that one end of the elliptical rim abuts the cul-de-sac or posterior wall of the vault, while the forward end seats within the notch of the pubic arch, indicated at 23. The cervix 2% is then positioned within the central channel It, illustrated clearly in Figure 3, and the entire unit is retained against accidental displacement by the expansion of the rim within the vault and its contact with the notch of the pubic arch and with the cul-de-sac. When so positioned the unit oiiers both support and protection to the cervix and to the adjacent walls of the vault by virtue of its own inherent strength and resilience.

Referring now'particularly to the second embodiment of the invention, illustrated in part in Figure 7, the construction is found to be identical to that previously described with the exception that within the rim H is positioned a coil spring 21, the convolutions of which closely encircle the flat spring It as illustrated to provide additional strength. The characteristics of the unit upon being depressed are those previously described in connection with the first embodiment and the use is identical.

Referring now particularly to the third embodiment of the invention, illustrated in Figure '8,-that construction also is identical to the first described construction with the exception that a circular coil spring 28 is positioned upon the inner side of the fiat conical spring it, both being embedded within the resilient rim H.

In Figure 9 is found illustrated the fourth preferred embodiment of the invention which is also like the first described embodiment with the exception that the small spiral Wire spring 29 is positioned outside ilat conical spring 13, both being embedded within rim I l.

While the particular constructions herein I .of flexible material integral with said ring.

2. A vaginal diaphragm comprising: an annular ring of resilient material substantially circular in section, a frusto-conical fiat non-extensible circular spring embedded in said ring, and presenting greater resistance to deflection against a force radial to said ring than to a force normal thereto and a thin sheet of flexible material integral with said ring and extended therefrom on the side adjacent the edge of said ring having the greatest peripheral length.

3. A vaginal diaphragm comprising: an annular ring of resilient material substantially circular in section, a frusto-conical flat non-extensible circular spring embedded in said ring, a spiral extensible coil spring arranged concentrically to said flat spring and embedded in said ring, and a thin sheet of flexible material integral with said ring and forming a closure therefor.

4. A vaginal diaphragm comprising: an annular ring of resilient material substantially circular in section, a frusto-conical fiat non-extensible circular spring embedded in said ring, a spiral extensible coil spring encircling said flat spring and embedded in said ring, and a thin sheet of flexible material integral with said ring and forming a closure therefor.

5. A vaginal diaphragm comprising: an" annular ring of resilient material substantially circular in section, a frusto-conical fiat non-extensible circular spring embedded in said ring, a 30 spiral extensible coil spring arranged concentrically Within said flat spring and embedded in REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS Number Name Date 2,234,494 Lay Mar. 11, 1941 2,234,495 Lay Mar. 11, 1941 2,249,316 Lay July 15, 1941 2,324,656 Lay July 20, 1943 FOREIGN PATENTS Number Country Date 557,914 Germany Aug. 28, 1931 

